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Tearing your anterior cruciate ligament (ACL) is a painful, frustrating process. However, the reconstruction technique your surgeon uses can make a huge difference in your recovery time, pain after surgery, and risk of re-injury.

One reconstruction method that has gained popularity in recent years is the quadriceps tendon autograft using the “all-inside” dual suspensory fixation technique. This ACL reconstruction technique leads to faster recovery times, less postoperative pain, and a lower risk of re-rupture than other autograft reconstruction techniques.

Dr. Brandon Shallop from the Orthopedic Center of Palm Beach County stands out as one of the only doctors in the area who performs the “all-inside” dual suspensory fixation technique. An expert in this technique, he is prepared to help you explore the best surgical options for your ACL injury. Read on to learn more about quadriceps tendon autograft ACL reconstruction using the “all-inside” dual suspensory fixation technique.

What Is Quadriceps Tendon Autograft ACL Reconstruction?

Quadriceps tendon autograft ACL reconstruction is a specific technique for ACL reconstruction that uses the quadriceps tendon as a graft source. Located above the knee, the quadriceps tendon works with the quadriceps muscle to extend the leg.

When surgeons reconstruct the ACL, they can harvest tissue either from the patient (autograft surgery) or from a donor (allograft surgery). Many surgeons agree that autograft surgery is superior for ACL reconstruction, specifically for successful knee function and laxity post-operation.

During ACL reconstruction, surgeons can take tissue from several parts of the patient’s leg: the patellar tendon, the hamstring, or the quadriceps tendon. While there are advantages to using each of these sources as the ACL graft, many surgeons prefer to utilize the quadriceps tendon for this surgery type.

Quadriceps tendon autograft reconstruction offers several advantages over other autograft options. A few primary benefits of this technique include:

  • More collagen fibrils available from the quadriceps tendon
  • Greater comparability to the native ACL strength
  • Increased ability for the quadriceps tendon to grow back following reconstruction
  • Less knee pain and numbness following surgery
  • Minimal risk of re-rupture, specifically in active patients
  • Minimal harvest site morbidity

Another significant advantage of this reconstruction method is that it is well suited to the all-inside dual suspensory fixation technique, which we will discuss below.

The “All-Inside” Dual Suspensory Fixation Technique

The “all-inside” dual suspensory fixation technique combines two reconstruction methods: “all-inside” placement and double fixation of the graft.

The “all-inside” technique for ACL reconstruction is a less-invasive surgery technique that uses small “poke-hole” incisions rather than large knee incisions. Surgeons who employ this technique position the quadriceps tendon graft under camera visualization, fixing it to the reconstruction site using tunnel pathways.

Meanwhile, the dual suspensory fixation technique uses two suspension sources — the femur and the tibia — to implant the graft during the ACL reconstruction. By double-fixing the graft, securing it above and below the ACL, this technique allows the graft to mimic the native ACL’s attachments and provide better mobility.

The “all-inside” ACL dual suspensory technique requires a decreased graft length compared to the length required for other reconstruction methods, producing a more negligible risk of harvest site morbidity. In addition, this reconstruction method requires a shorter recovery time, making it ideal for athletes or active patients who need to return to their previous lifestyles quickly.

Why Choose the “All-Inside” Dual Suspensory Fixation Technique?

The “all-inside” dual suspensory fixation technique offers several benefits to you as the patient. A few of the most significant include smaller incisions, decreased postoperative anterior knee pain, and the strongest biomechanical construct in ACL surgery.

Smaller Incisions

The “all-inside” ACL reconstruction method uses smaller incisions inside the knee than other surgery methods. To accomplish this reconstruction, surgeons create small poke-hole incisions and use a camera to visualize the reconstruction area.

These tiny incisions provide cosmetic benefits, producing less noticeable scars. They also heal faster than traditional incisions, decreasing recovery time.

Decreased Postoperative Anterior Knee Pain

The “all-inside” dual suspensory fixation technique leads to less pain following ACL reconstruction surgery. Experiencing less severe pain allows you to return to your everyday life faster and begin completing light activity in a few months or less.

Most patients regain normal range of motion of their knees after a course of rehabilitation, and many achieve complete healing and graft incorporation after a 4.5-month recovery period.

Strongest Biomechanical Construct in ACL Surgery

Applying a graft through the “all-inside” dual suspensory fixation technique creates the strongest construct within the ACL surgery field. This method produces stronger biomechanical tensile properties, allowing the graft to withstand more activity and weight than other reconstruction techniques allow.

Contact Us Today

The best way to determine if quadriceps tendon autograft ACL reconstruction using the “all-inside” dual suspensory fixation technique is right for you is to schedule a consultation with Dr. Brandon Shallop at Orthopedic Center of Palm Beach County. Dr. Shallop will review your medical history, X-rays, and symptoms and identify the most suitable reconstruction method for your needs.

Call us today at 561-967-6500 to schedule a consultation at one of our three offices:

  • Lake Worth Office
  • Boynton Beach Office
  • Wellington Office


Dr. Brandon Shallop sees patients in each of these locations and is ready to meet with you to discuss your ligament reconstruction options. Contact our office today to make an appointment and begin your road to recovery.